Uri kurwadziwa nemapfudzi uye kushaya simba kweruoko here? Ingave Pancoast Bumor!

Unonzwa kurwadziwa kwepafudzi kusingatsananguriki here, dzimwe nguva padivi pemutsipa wako, pamwe chete nekurwadziwa pasi peruoko rwako, kusanzwa simba muruoko rwako? Dzimwe nguva tinogona kufunga kuti kungori kugomara kana tsinga yakamanikana. Zvisinei, zviratidzo izvi dzimwe nguva zvinogona kuva chiratidzo chechimwe chinhu chakakomba. Ndiyo mamiriro atichataura nezvawo nhasi, anonzi Pancoast Tumor.

Chii chinonzi Pancoast Bumor? Zvichitaurwa zviri nyore...

Funga nezvazvo, bundu rePancoast rudzi rwekenza yemapapu . Asi zvinoshamisa zvishoma. Nekuti rinoumbwa pamusoro chaipo pemapapu ako, pamusoro pembabvu yako yekutanga, pamusoro. Kusiyana nedzimwe kenza dzemapapu, bundu rePancoast harikonzeri kukosora kana kurwadziwa kwechipfuva . Pane kudaro, vanhu vane bundu iri vanowanzo nzwa kurwadziwa kwakanyanya kwemafudzi uye kushaya simba kweruoko . Vanachiremba vanodana musanganiswa wezviratidzo izvi kuti "Pancoast syndrome." Pancoast syndrome haikonzeri zviratidzo zvekenza yemapapu yakajairika, saka zvinogona kutora nguva kuti zviongororwe bundu iri. Muzviitiko zvakawanda, kuongororwa kwakajeka hakuitwi kusvika kenza yapararira kune tsinga dziri pedyo netsinga dzeropa. Bundu rePancoast rinotumidzwa zita renyanzvi ye radiologist yakatanga kurondedzera pakutanga kwezana remakore rechi20. Rimwe zita rawo ibundu re sulcus repamusoro.

Kune mhando dzeizvi here?

Ehe, kune mhando dzakasiyana-siyana dzemabundu ePancoast. Akanyanya kukura ndeaya:

• Kenza dzemapapu dzisiri dzemasero madiki - semuenzaniso, adenocarcinomas uye squamous cell carcinomas.
• Kenza dzemapapu diki.

Ruzhinji rwemabundu ePancoast rudzi rwekenza inonzi adenocarcinomas . Mabundu aya anotangira mumitsetse yemhepo yako uye mualveoli (tubhegi tudiki twemhepo mumapapu ako), kunyanya mumasero eglandular anogadzira mucus.

Dambudziko iri rakajairika zvakadii?

Matumbu emumapapu ePancoast haawanzoitiki , zvichiita kuti pave neasingasviki 5% yematumbu ese emapapu.

Ndezvipi zviratidzo zveizvi? Ngatinyatsoongororai!

Plexus yako yebrachial inokanganiswa nebundu rePancoast.Nhare iyi inogona kudzvinyirirwa. Nhare iyi inomhanya kubva pachipfuva chako chepamusoro ichipfuura nemumutsipa wako ichienda mumaoko ako. Kana kumanikidzwa uku kwaitwa, zviratidzo zvakasiyana zvinogona kuitika. Ndosaka vanachiremba vachiidaidza kuti Pancoast syndrome kana kuti Pancoast-Tobias syndrome. Zviratidzo izvi zvinoitika kudivi rimwe chete nebundu . Semuenzaniso, kana bundu riri mumapapu ako ekurudyi, zviratidzo zvichabatawo divi rekurudyi remuviri wako. Zviratidzo zvebundu rePancoast zvinogona kusanganisira:

• Kurwadziwa kwakanyanya kwepafudzi : Izvi zvinogona kusanganisira kurwadziwa kwebanga repafudzi rako.
• Marwadzo anoyerera pasi peruoko: Marwadzo aya anogona kumira paruoko, pamusoro pemunwe mudiki.
• Kushaya simba muruoko neparuoko.
• Kurwadziwa kwemutsipa.
• Kurwadziwa muchikamu chepamusoro chembabvu.
• Kuzvimba kweruoko rwepamusoro.
• Kurasikirwa nehunyanzvi mumaoko neminwe.
• Kunzwa kurwadza kana kuti kusanzwa simba muruoko.
• Kuneta.
• Kusimba kwechipfuva.
• Kuderedza uremu pasina chikonzero.

Vanhu vanosvika 50% vane bundu rePancoast vanowanawo chirwere chinonzi Horner's syndrome , chinogona kukonzera zviratidzo zvakaita se:

• Kupukuta kumeso.
• Maziso akarembera (ptosis).
• Maziso anotenderera mukati (enophthalmos).
• Kushaya ziya (anhidrosis).

Chii chinokonzera izvi? Ndezvipi zvinhu zvinokonzera njodzi?

Zvinokonzera uye zvinokonzera njodzi yekenza yePancoast zvakafanana nedzimwe kenza dzemapapu. Zvinhu zvikuru zvinokonzera njodzi ndeizvi:

• Kusvuta .
• Kusvirwa neutsi hwemunhu anoshandiswa nevamwe.
• Kugara kwenguva refu uchiona zvimwe zvinhu zvakaita seasbestos, radon gas, uye heavy metals.

Ingofungai, kana tikazvipinza muzvinhu izvi, tiri kukuvadza mapapu edu tisingazive. Saka zvakakosha kuti tingwarire izvi.

Izvi zvinopararira sei?

Gomarara rinopararira kana masero egomarara achibva pagomarara rekutanga, ofamba nemuropa rako kana mumasero elymph, ogadzira magomarara matsva mune dzimwe nhengo dzemuviri wako. Magomarara ePancoast anogona kupararira kubva kumusoro kwemapapu kuenda kunzvimbo dzinotevera:

• Chipfuva chepamusoro.
• Kupidiguka.
• Mbabvu dzechipfuva.
• Mitsipa yeropa iri pedyo nemaoko.

Kupararira kwegomarara uku kunzvimbo dziri kure kunonzi metastasis .

Izvi zvinoonekwa sei?

Pakutanga, bundu rePancoast harionekwe zviri nyore paX-ray yechipfuva ine mativi maviri. Ndosaka zvichigona kuoma kuona. Kana chiremba akafungidzira kuti bundu rePancoast rine zviratidzo zvako, vanogona kukurudzira mimwe miedzo yekuongorora, yakaita se:

• Mimwe miedzo yemifananidzo.
• Kuongororwa kwetsono.
• Kuvhiyiwa kwe thoracoscopy nemavhidhiyo (VATS).
• Kuvhiyiwa kweTsamba.

Miedzo yemifananidzo

Tekinoroji yepamusoro yekufungidzira inogona kubatsira chiremba wako kuti anzwisise mapapu ako zvakajeka. Anogona kuraira bvunzo dzakadai sedzinotevera:

• CT scan (CT - computed tomography scans).
• Kuongororwa kwePET (positron emission tomography scans).
• MRI scan (MRI - magnetic resonance imaging).

Mhando idzi dzekuongorora dzinogona kupa ruzivo rwakawanda, senge saizi yebundu, nzvimbo yaro, uye kana rakapararira kune dzimwe nzvimbo.

Kuongororwa kwetsono netsano

Mukuongorora netsono, chiremba anotora sampuli yemvura, nyama, kana masero kubva mubundu risingawanzoitiki. Muenzaniso wacho unozotumirwa kurabhoritari yezvirwere kuti uongororwe zvakare. Ndipo chete patinoziva chokwadi kana iri kenza uye kuti imhando ipi.

Kuvhiyiwa kweThoracoscopy (VATS)

Munguva iyi, chiremba anoita kucheka kudiki pachipfuva chako uye anoisa thoracoscope (chubhu diki ine kamera diki pairi). Izvi zvinomubvumira kutarisa mukati mechipfuva chako uye kutarisa bundu kana zvimwe zvisina kunaka. Kana zvikawanikwa, sampuro yenyama inotorwa yotumirwa kurabhoritari kuti iongororwe.

Kuvhiyiwa kweChifuva

Muzvimwe zviitiko, chiremba angafanira kuita chirauro. Pakuita izvi, vanocheka chipfuva chako kurudyi kana kuruboshwe, pakati pembabvu. Izvi zvinovabvumira kuona mapapu akakanganiswa zvakajeka uye kutora biopsy yenyama isina kujairika. Muzviitiko zvakawanda, vanobvisawo bundu panguva imwe chete. Izvi zvinokudzivirira kubva pakuvhiyiwa kakawanda.

Ngatidzidzei nezvekukura kwegomarara iri.

Kufanana nedzimwe mhando dzekenza yemapapu, vanachiremba vanoisa mumapoka matumbu ePancoast vachishandisa nzira yekuongorora kenza . Vanoshandisa nhamba dzechiRoma (I, II, III, IV) uye subtypes (A, B) kutsanangura kuti bundu racho rakura sei uye kuti rapararira kusvika papi. Kune tumbumbu dzePancoast, vanachiremba vanoshandisa mavara T, N, M uye nhamba 1, 2, 3, 4 kuratidza kuoma kwechirwere ichi:

• Vara T rinoreva kukura kwebundu rako uye kuti rapararira kusvika papi.
• Vara N rinoreva kana kenza yapararira kusvika kuma lymph nodes ako.
• Vara M rinoratidza kana kenza yapararira kune dzimwe nzvimbo dziri kure dzemuviri (metastasis) .

Matumbu ePancoast anowanzoonekwa padanho ripi?

Nekuti bundu rePancoast rakaoma kuona pakutanga, mazhinji anowanikwa padanho reT3 kana T4. T3 zvinoreva kuti kenza yapararira kumadziro echipfuva chako kana kutsinga dzako dzetsinga. T4 zvinoreva kuti kenza yapararira kune zvimwe zvivako, zvakaita setsinga dzako dzemusana kana musana. Ichi chirwere chakakomba zvikuru.

Kurapwa kwacho chii?

Izvi zvinoenderana nekuti bundu riri kupi uye kuti kenza yapararira kusvika papi. Kune nzira dzakasiyana siyana dzekurapa:

• Kurapwa kwemasero eropa (chemoradiation) nekuvhiyiwa.
• Chemoimmunotherapy uye kuvhiyiwa.
• Kurapwa nemakemikari (chemotherapy) uye immunotherapy.
• Kurapa nemwaranzi.
• Kurapwa kwakanangana.

Kuchemwa kweropa nekuvhiyiwa

Kuvhiyiwa ndiyo nzira yakanakisisa yekurapa pese pazvinogoneka. Zvisinei, usati wavhiyiwa, vanachiremba vanogona kukupa chemoradiation - musanganiswa wechemotherapy neradiation therapy - kuderedza bundu. Kuvhiyiwa kwekubvisa bundu rePancoast kunogona kuoma zvishoma. Kazhinji, chiremba anovhiya anofanira kubvisa mbabvu mbiri dzepamusoro. Vangatofanirawo kubvisa tsinga huru voitsiva ne vascular graft - chubhu yekugadzira inobvumira ropa kuyerera. Chiremba wako anokutsanangurira zvese izvi usati wavhiyiwa.

Chemoimmunotherapy nekuvhiya

Mune zvimwe zviitiko, vanachiremba vanogona kukurudzira kuvhiyiwa uye chemoimmunotherapy.- kureva kuti, musanganiswa we chemotherapy ne immunotherapy - unoshandiswa. Kunyange zvazvo chemotherapy ichiuraya masero ekenza uye ichinonotsa kukura kwebundu, immunotherapy inokurudzira masoja emuviri wako kuti abatsire kurwisa kenza.

Kurapwa nemakemikari (chemotherapy) uye immunotherapy

Dzimwe nguva, kuvhiyiwa hakusi sarudzo. Muzviitiko zvakadaro, timu yako yezvekurapa inogona kukurudzira musanganiswa we chemoradiation ne immunotherapy.

Kurapa nemwaranzi

Kana kuvhiyiwa kusingagoneke uye kenza yapararira kune dzimwe nhengo dzemuviri, chiremba wako anogona kukurudzira kurapwa nemwaranzi chete kudzora kukura kwekenza. Nzira iyi yekubatsira inogona kuderedza kenza uye kuderedza zviratidzo zvako.

Kurapa kwakanangana

Vamwe vanhu vanobatsirwa nekurapwa kwakanangana . Kurapwa uku kunotarisa kushanduka kwemajini kunoita kuti masero ane hutano ave masero ekenza. Kuti aone kana uri munhu akakodzera kurapwa kwakanangana, chiremba achaedza masero ako ekenza kuti aone kana aine mareceptor chaiwo emapuroteni chaiwo. Kana uine mibvunzo nezveizvi, taura nachiremba wako.

Izvi zvinogona kudzivirirwa here?

Kunyange zvazvo bundu rePancoast risingadzivirirwe zvachose, pane zvinhu zvaunogona kuita kuti uderedze njodzi yako yekuva nerudzi urwu rwekenza:

• Dzivisa kusvuta nezvimwe zvigadzirwa zvefodya. Kana uchisvuta, taura nachiremba wako kuti akubatsire kurega.
• Dzivisa kusvuta fodya yemumwe munhu zvakanyanya sezvinobvira.
• Iva nechokwadi chekuti nharaunda yako haina makemikari anokuvadza akadai seasbestos .

Kunyangwe izvi zvingaita sezvinhu zvidiki, zvinogona kukanganisa hutano hwako nekufamba kwenguva.

Uyezve, kana mumwe munhu mumhuri yako aine nhoroondo yekenza yemapapu, kana kuti kana uine mukana wakakura wekuva nekenza yemapapu, zvakanaka kubvunza chiremba wako nezvekuongororwa kwekenza yekudzivirira .

Chii chaunotarisira kana uine bundu rePancoast?

Kana ukaonekwa uine bundu rePancoast, chiremba wako achagadzira timu yekurapa yakagadzirirwa zvaunoda. Chikwata chako chekurapa chinogona kusanganisira:

• Vanachiremba vechipfuva.
• Vanachiremba vepfungwa.
• Vanachiremba veOncologists , kureva, vanachiremba veOncologists vezvekurapa, vanachiremba veOncologists vekuvhiya, uye vanachiremba veOncologists vane radiation.

Chikwata chenyu chezvekurapa chichakurudzira kurapwa zvichienderana nehukuru hwebundu rePancoast, kwariri, uye kana kenza yacho yapararira kune dzimwe nzvimbo.

Nzungu idzi dzinokura nekukurumidza zvakadii?

Kazhinji, bundu rePancoast rinokura zvishoma nezvishoma . Zvisinei, kashoma, bundu rinogona kukura nekukurumidza. Chiremba wako acharamba achitarisa kukura kwebundu nguva nenguva usati warapwa, panguva yekurapwa, uye mushure mekurapwa.

Chii chinotarisirwa kuti munhu ararame?

Mumakore mashoma apfuura, kufambira mberi mune tekinoroji kwakaita kuti huwandu hwevanhu vanorapwa kubva kuPancoast bundu huwedzere zvishoma nezvishoma. Asi kuchine zvakawanda zvekudzidza nezvechirwere ichi. Huwandu hwevanhu vane bundu rePancoast rinorapwa nekukurumidza hunosvika 30% kusvika 50%. Izvi zvinoreva kuti hafu yevanhu vanoonekwa vaine bundu rePancoast vachiri vapenyu makore mashanu mushure mekuonekwa. Asi zvakakosha kuyeuka: Huwandu hwevanhu vanorarama hunongofungidzirwa chete. Havakuudze kuti uchararama kwenguva yakareba sei kana kuti kurapwa kwacho kuchashanda zvakanaka sei kwauri. Taura nachiremba wako kuti unzwisise kuti kenza iyi inokukanganisa sei.

Unofanira kutsvaga mazano ekurapa rini?

Kana uine kurwadziwa kwakanyanya kwemafudzi, kurwadziwa kweruoko, kushaya simba kweruoko, kana zvimwe zviratidzo zvebundu rePancoast, unofanira kuona chiremba nekukasika. Kuonekwa nekukurumidza ndiko kwakakosha.

Mibvunzo ipi yaunofanira kubvunza chiremba?

Kana iwe kana mumwe munhu waunoda akaonekwa kuti ane bundu rePancoast, ungada kubvunza chiremba wako mibvunzo iyi:

• Bundu riri kupi?
• Yakapararira here kumatishu akapoteredza?
• Yakapararira kunzvimbo dziri kure dzemuviri here?
• Ndine nhanho ipi yekenza?
• Ndedzipi nzira dzekurapa dzandinadzo?
• Ndichakwanisa here kushanda panguva yekurapwa?
• Kurapwa kunowanzotora nguva yakareba sei?
• Maonero angu akaita sei?

Iri ibundu rePancoast here kana kuti tsinga yakapwanywa?

Vamwe vanhu vane bundu rePancoast vanoti zviratidzo zvavo zvinotanga nekunzwa "kupwanyika kwetsinga" . Kana uine rudzi urwu rwekurwadziwa uye rukagara kweanopfuura mavhiki maviri, zivisa chiremba. Zvingave zvisiri izvo zvakajairika.

Mharidzo Yekupedzisira Yekuenda Kumba

Matumbu emuPancoast anotangira kumusoro kwemapapu ako. Akasiyana nemamwe marudzi ematumbu emumapapu nekuti akaoma kuona pakutanga. Kuziva kuti une bundu remuPancoast kunogona kuva chiitiko chinovhiringidza zvikuru. Zvinogona kunetsa kuronga zvekuita zvinotevera.

Asi yeuka kuti chiremba wako aripo kuti akubatsire. Mubvunze rumwe ruzivo nezvemamiriro ako chaiwo. Kana uchikwanisa, batana neboka rekutsigirana, kungave uri iwe pachako kana online. Kutaura nevamwe vari kusangana nezvinhu zvakafanana nezvauri kusangana nazvo kunogona kubatsira zvikuru pahutano hwako hwepfungwa, hwemanzwiro, uye hwemweya. Usambotambura uri wega.

 Bundu rePancoast, kenza yemapapu, kurwadziwa kwepafudzi, zviratidzo zvekenza, kurapwa kwekenza, kenza yemapapu, kurwadziwa kwepafudzi